Individual
MRS. TARA L LASUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
1325 LOUISVILLE AVE, MONROE, LA 71201
(318) 807-1500
(318) 807-1504
Mailing address
130 DESIARD ST STE 355, MONROE, LA 71201-7363
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09495R
LA
225100000X
Physical Therapist
PT4063
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2443887
—
LA
Enumeration date
10/19/2006
Last updated
06/12/2019
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